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Rx for reducing infant mortality: Increase education, lessen poverty
YOUNGSTOWN
Black Mahoning Valley medical leaders say education and reducing poverty are key to improving the dismal infant mortality rate among blacks and whites.
Though formal education is crucial to improving the poverty level, Drs. David M. Davis and Rodney E. Hill say the education that could make a dent in the mortality rate is more about what a woman needs to know and do when she is pregnant.
As of 2012, the latest statistics available, Ohio had the worst infant mortality rate of any state in the nation for black babies who die before they are a year old, according to the National Center for Health Statistics.
“Education definitely can play a role in improving the IMR from the standpoint of where does a woman go for pregnancy care,” said Dr. Hill, a specialist in obstetrics, gynecology (ob-gyn) and infertility.
A board-certified obstetrician with specialized training in the management of pregnancy, labor and the postpartum (postnatal) period, Dr. Hill owns Associates in Women’s Health of the Mahoning Valley in Youngstown.
Women’s choices for pregnancy care are an ob/gyn, a family practitioner or a certified nurse midwife, Dr. Hill said.
All three can handle a normal pregnancy, but women with high-risk factors, such as a previous pre-term birth, hypertension, diabetes and obesity, should see an ob-gyn from the beginning.
“That’s where education comes in. They need to know that a specialist is available and called for,” Dr. Hill said.
“If a woman comes to an ob-gyn, he can take her medical history and identify high-risk factors. Also, high-risk factors can develop during pregnancy,” he said.
He noted most women living in poverty don’t have health insurance and think they have to wait until they have a Medicaid card to receive benefits. They need to know that Medicaid will “back date” coverage up to three months, and that while not all doctors will accept “Medicaid pending” patients, he does.
Not seeing an ob-gyn until halfway through a pregnancy is a huge issue, said Dr. Davis, medical director for the Youngstown Board of Health.
Transportation can also be an issue and result in missing medical appointments. Pregnant women need to know that Medicaid will provide transportation, Dr. Hill said.
“We need to get this type of information out to leaders in the black community and bring it to the masses. It’s frustrating that women don’t always know what dangers exist and what benefits are available to them,” he said.
Poverty is one of the root causes of low-birth weight and complications during pregnancy, said Dr. Davis, owner of DMHD Family Practice on Belmont Avenue.
With poverty comes lack of knowledge of what’s available in health care and understanding that high-risk behaviors, such as alcohol, drug and tobacco use during pregnancy, all can contribute to preterm birth, malformation and Sudden Infant Death Syndrome.
“Young people don’t know enough about having a baby and how to take care of it,” he added. The bottom line is “if you’re pregnant, you need to be seen by your health-care provider as soon into the pregnancy as possible.
“If you don’t have a health-care provider, there are clinics and hospitals with programs to help those who don’t have health-care insurance.” Dr. Davis said.
Deatrice “Dee” Traylor of Youngstown, coordinator of Humility of Mary Health Partners’ Resource Mothers Program, believes racism is partly behind the disproportionate number of black infant deaths in Ohio and the Mahoning Valley.
She said that among the causes are economic instability, lack of affordable housing and access to education.
“How can you concentrate on education and medical care when you need a place to live and food to eat?” Traylor said.
Racism also impacts the ability of blacks to get jobs, and as a society, we don’t discuss that, said Traylor, a licensed social worker who has worked at St. Elizabeth Health Center for 24 years.
Education makes a difference in the type of job a person can get and in the attitude toward the health system, said Traylor who graduated from The Rayen School in 1978 and received her bachelor’s degree in social work from Youngstown State University.
“It’s a problem that can be fixed if we are willing to work together — the public and private sectors of the community — to improve life for all,” she added.
“I don’t think anyone wants to have an unhealthy baby, and education is the key,” said Dr. Davis, who was born and raised in Youngstown and graduated from East High School.
“My main thing is that we, as a people, need to be educated on how to prevent infant mortality ... stop doing things that hurt ourselves and the fetus, such as using alcohol, drugs and tobacco and other risky behavior.
“We need to learn how to take care of a child or an infant ... how to put them to bed. A baby can’t sleep in the same bed with an adult. That goes to education. If you don’t know, you don’t know,” Dr. Davis said.